Kane, E, Howell, D, Smith, A et al. (4 more authors) (2017) Emergency admission and survival from aggressive non-Hodgkin lymphoma: A report from the UK's population-based Haematological Malignancy Research Network. European Journal of Cancer, 78. pp. 53-60. ISSN 0959-8049
Abstract
Background Non-Hodgkin lymphoma (NHL) is often diagnosed after emergency presentation, a route associated with poor survival and an indicator of diagnostic delay. Accounting for around half of all NHLs, diffuse large B-cell lymphoma (DLBCL) is of particular interest since although it is potentially curable with standardised chemotherapy it can be challenging to identify at an early stage in the primary care setting. Patients and methods Set within a socio-demographically representative United Kingdom population of around 4 million people, data are from an established patient cohort. This report includes all patients (≥18 years) diagnosed with DLBCL 2004–2011 (n = 1660). Emergency admissions were identified via linkage to Hospital Episode Statistics using standard methods, and survival was examined using proportional hazards regression. Results Two out of every five patients were diagnosed following an emergency admission, and this was associated with advanced disease and poor survival (p < 0.001). Among the 80% of patients treated with curative chemotherapy, survival discrepancies emerged at the point of diagnosis; the adjusted hazard ratio (emergency versus non-emergency) at one month being 4.0 (95% confidence interval 1.9–8.2). No lasting impact was evident in patients who survived for 12 months or more. Conclusion Emergency presentation impacts negatively on DLBCL survival; patients presenting via this route have significantly poorer outcomes than patients with similar clinical characteristics who present via other routes.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2017 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/ licenses/by/4.0/). |
Keywords: | Non-Hodgkin lymphoma; Emergency presentation; Emergency presentation; Diffuse-large b-cell lymphoma |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > Institute of Molecular Medicine (LIMM) (Leeds) > Section of Oncology and Clinical Research (Leeds) The University of York > Faculty of Sciences (York) > Health Sciences (York) |
Depositing User: | Symplectic Publications |
Date Deposited: | 20 Apr 2017 11:06 |
Last Modified: | 20 Apr 2017 11:06 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.ejca.2017.03.013 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:115267 |